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Ability to 'Hold Your Liquor' May Raise Your Alcohol Abuse Risk

People who suffer fewer immediate alcohol-related effects after a night of heavy drinking — no hangover, for example — may be at greater risk for alcohol dependence and abuse as their tolerance develops.

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TUESDAY, Jan. 22, 2013 — If someone you know talks proudly about being able to “hold their liquor,” you may want to tell them it's not something to brag about.

In a study published in the March issue of Alcoholism: Clinical & Experimental Research, researchers at Arizona State University and Yale University report that people who can hold their liquor may enjoy short-term benefits — like being able to function at work after a night of drinking because they don't have a hangover — but may face longer-term health problems as their tolerance to alcohol develops.

Past long-term studies found that people who have a low subjective response to alcohol — meaning they don’t feel immediate alcohol effects as much as others — are at risk for alcohol dependence and alcohol abuse.

In the new study, led by William R. Corbin, PhD, associate professor and director of clinical training in the Department of Psychology at Arizona State University, researchers looked at the association between early subjective response to alcohol and acquired tolerance, as well as at drinking behavior and alcohol-related problems, in a group of 113 heavy-drinking young adults, 75 of whom were men and 38 women. The average number of drinks consumed by the study subjects per week was roughly 24. (Heavy drinking is generally defined as five or more drinks for men on one occasion, or four or more drinks on one occasion for women per week.)

Dr. Corbin found that people who did not feel alcohol effects as strongly or could "hold their liquor" reported fewer immediate consequences of drinking, such as:

Having problems at work

Being hung-over

Getting into physical fights

Going to work or school high or drunk

Neglecting responsibilities

Passing out, fainting, or blacking out

Corbin's findings were consistent with prior research on the topic: Both initial subjective response and alcohol tolerance were related to drinking behavior, with heavier drinking associated with low initial subjective response to alcohol and greater acquired tolerance.

“In the short term, being able to hold your alcohol may allow you to avoid some consequences because you’re not feeling as intoxicated, but the problem is, that allows those people to continue drinking more heavily over time, which ultimately increases their risk of serious alcohol problems,” says Corbin.

A low subjective response to alcohol may develop in someone who drinks heavily over time, Corbin says, resulting in people feeling less intoxicated than they had in the past after drinking the same amount.

“Tolerance is a well-established correlate of alcohol problems and is one of the diagnostic criteria for alcohol dependence,” Corbin says.

Is Alcohol Tolerance Genetic?

Because studies of the subjective response to alcohol must be conducted with participants who are 21 years or older, some subjects may already have considerable drinking experience, making it difficult to determine whether differences in subjective response are due to genetic or individual differences or if they should be attributed to differences in tolerance.

Corbin notes that those with a positive family history of alcohol abuse are less responsive to the effects of alcohol, which places them at greater risk.

“What’s important is that many people believe that if they can hold their alcohol, they are at low risk for alcohol problems. I think our study may help explain why that’s the case, because initially that may be true," says Corbin. "But what’s important is that people know that being able to hold your alcohol puts you at heightened risk for long-term alcohol problems. The worry is that people who have that belief continue to drink heavily, thinking they are fine, and those really are the ones we’re most worried about.”

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